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General NPI Number Information
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NPI Number | 1700459575
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Entity Type | Individual
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Provider Name | KATELIN ROSE THAMES MA, LPC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 4644 WITHERS DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405
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Country | US
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Telephone | 843-813-9717
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Fax |
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Provider Business Mailing Address
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Address Line | 4644 WITHERS DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-6772
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Country | US
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Telephone | 843-937-1934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | TPMC4866
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MI-0000180
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC10001993
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8219
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8219
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License Number State | SC
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